Adjuvant chemotherapy versus observation following neoadjuvant therapy and surgery for resectable stage I-II pancreatic cancer.
Publication/Presentation Date
9-1-2022
Abstract
BACKGROUND: Neoadjuvant therapy (NT), either with systemic treatment alone or in combination with radiation, is often utilized in the management of pancreatic adenocarcinoma to increase the likelihood of margin-negative resection. Following NT and resection, additional adjuvant chemotherapy (AC) can be considered for select patients and has been shown to improve overall survival (OS). This National Cancer Data Base (NCDB) analysis was performed to evaluate the outcomes of AC versus observation for resected pancreatic adenocarcinoma treated with NT.
METHODS: The NCDB was queried for primary stage I-II cT1-3N0-1M0 resected pancreatic adenocarcinoma treated with NT (2004-2015). Baseline patient, tumor, and treatment characteristics were extracted. The primary endpoint was OS. With a 6-month conditional landmark, Kaplan-Meier analysis, multivariable Cox proportional hazards method, 1:1 propensity score matching were used to analyze the data.
RESULTS: A total of 1737 eligible patients were identified, of which 1247 underwent postoperative observation compared to 490 with AC. The overall median follow-up was 34.7 months. The addition of AC showed improved survival on the multivariate analysis (HR 0.78, p
CONCLUSION: Using propensity score matched analysis, our findings suggest a survival benefit for adjuvant chemotherapy compared to observation following NT and surgery for resectable pancreatic adenocarcinoma, especially in patients with smaller tumors. Prospective studies are needed to identify subset of patients that would benefit from adjuvant chemotherapy.
Volume
21
Issue
3
First Page
383
Last Page
392
ISSN
1460-3969
Published In/Presented At
Ma, S. J., Serra, L. M., Bartl, A. J., Han, H. R., Fekrmandi, F., Iovoli, A. J., Hermann, G. M., Yu, H., & Singh, A. K. (2022). Adjuvant chemotherapy versus observation following neoadjuvant therapy and surgery for resectable stage I-II pancreatic cancer. Journal of radiotherapy in practice, 21(3), 383–392. https://doi.org/10.1017/s1460396921000194
Disciplines
Medicine and Health Sciences
PubMedID
36016861
Department(s)
Fellows and Residents
Document Type
Article